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CORDIS tamponada — initial sign of lung adenocarcinoma
Abstracts Training; N.N. Alerandrov Medical Radiology (RIOMR),
Research Minsk,
Institute Belarus.
of Oncology
and
From 1970 through 1989, 112 small-cell lung cancer (SCLC) patients received surgical treatment and combination therapy at the Thoracic Department of RIOMR. As one of the components of the therapy, 35 patients were i.v. administered 19sAu with total activity of 1.5-1.9 GBq during the first 5 days after surgery. Of the total number of SCLC patients, 23% survived for 5 years: 26% without metastases in regional lymph nodes and 10% with N1,2 SCLC combination treatment produced the best results in TlNOMO cases: 53% of the patients survived for 5 years. The combination of surgery and subsequent i.v. “‘Au isotope resulted in 5-year survival for 36% of SCLC patients. We consider it most advisable to include the surgical component in the definitive treatment of stage I (TlNO and T2MO) SCLC. In these cases it is preferable to employ either preoperative radiotherapy with enlarged and large dose fractionation (‘ITD 20 to 30 Gy) or postoperative i.v. “sAu. The remote results of stage II and III SCLC combination therapy are poor; multimodality treatment should be applied for these stages. CORDIS
tamponada
-
initial
sign of lung adenocarcinoma
Videnovic-Ivanov J, Vucinic V, Radosavljevic T, Skodric V, Filipovic S. Institute for Lung Disease and TB, Belgrade, Yugoslavia
During the last 5 years we have found a higher number of patients with adenocarcinoma, especially in women, compared with the previous 5 years. The aim of this work is to emphasise the one sign manifestations of lung adenocarcinoma. Among this group of patients we analysed one group of nine pts (all were female), mean age 43.2 years. All of them were hospitalized because of dyspnea and radiographic manifestations of pleural effusion. The radiographic finding of totally enlarged heart shadow was the main finding and required ultrasonographic examinations. After exploration, pericardy punction might be obtained: in four pts there was haemmorhagic effusion while in the rest of the pts pericardial effusion was serosy. After that, cytologic examination was obtained in nine pts, in four of them cells of adenocarcinoma were found. In the rest of the pts, five pts, the diagnosis of adenocarcinoma was obtained after pleural biopsy. Pleural effusions were found in five pts on the left side, in hvo on the right side and in two pts bilaterally. Medical treatment was carried out in all of them: specific oncologic therapy in five pts. In two pts exitus letalis were obtained soon after admission to the hospital - mean time was 27.2 days, in four pts exitus letalis manifested in a mean time of 6.4 months but in three pts specific oncologic therapy was still delivered periodically and the results arc encouraging. Incidence and chemoradiotherapy
clinical significance of for advanced non-small
anaemia during cell lung cancer
Zemanovh M, Petruielka L, Zatloukal P, Judas L, Krejbich M. Dept. of Oncology, Czech Rep.
I”’ Medical
Faculty,
Charles
Uniu.,
Prague,
There are still too little data to assess the overall importance of anaemia in radiotherapy. However, there is strong
S61
evidence that a low Hb concentration is detrimental to local control and even within the range of normal Hb, variations may change the radiation response. While there seems to be conflicting data in assessing the overall importance of anaemia in radiation, there are some data that clearly show that uncorrected anaemia is detrimental to local control in some sites. Chemotherapy combined with radiotherapy may improve the disease control but commonly causes anaemia or worsens the mild anaemia associated with cancer. We evaluated incidence of anacmia in a group of patients treated with concurrent chemoradiotherapy using cisplatin plus vinorelbin (Zatloukal, Petruielka, Zemanoti et al. ASCO 1998). Results: From 7/96 to 12/97 19 pts with non-small-cell lung cancer were treated with concurrent chemoradiotherapy, 14 M, 5 F. Mean age 60 (range 44-70). Clinical stage IIIA: 3, IIIB: 16. Hb before treatment start: 1 patient Hb = 10 g/dl, 3 Hb < 11. Mean Hb before treatment start 13.1, mean Hb at the end of radiation 10.8. Mean nadir Hb during treatment 9.8. Number of patients with nadir Hb < 10.5: 10 (63.1%). Mean Hb drop 3.2. We evaluated treatment response relation to age, sex, PS, stage, number of chemotherapy cycles, Hb level before treatment start, at the end of radiation and Hb nadir by univariate analysis. Conciusion: We observed a significant proportion of patients with a drop of haemoglobin during the treatment course. Treatment response is in statistically significant correlation with the number of chemotherapy cycles. There was no correlation with other evaluated factors. WC will start a randomized trial to evaluate the effects of preventing anaemia with erythropoietin for patients with lung cancer undergoing concurrent chemoradiotherapy. Supported by grant IGA Mzd 3790-3.
Multidisciplinary
approach
to microcytoma
of the lung
Ruggieri M, Scocchera F, Carncvale L, Mascaro A, Misciagna A, Haughn C*. Uniuersi~ of Rome, Rome, Italy. *Ohio State University,
Columbus,
USA.
Twenty-six patients were diagnosed with microcytoma of the lung in stages I, II, and IIla. Our treatment strategy for stage I disease included surgery followed by chemotherapy. In stages II and IIIa we used prcopcrativc chemotherapy and thoracic irradiation followed by surgical treatment and adjuvant chemotherapy. Prophylactic cranial irradiation was rcscrvcd for some patients in complete remission. Mean survival rates were 16 months for stage I, 10 months for stage II, and 6 months for stage IIIa disease. For many years surgery was considcrcd contraindicated in the treatment of pulmonary microcytoma. Now, a multidisciplinary approach is being used in which surgery has a crucial role. Accurate staging is important for determining treatment. A review of literature shows that the use of surgery, chcmothcrapy and radiotherapy arc all important in treatment of microcytoma. Chemotherapy is used preopcratively to improve local control, decrease ncoplastic mass, induce histological regression, and as adjuvant therapy. Radiotherapy is shown to be affective prcopcrativcly to rcducc local mass and prophylactically for ccrcbral metastasis. Surgery is crucial to irradicatc the neo-plastic mass, improve staging accuracy, dccrcase local recurrence, and allow less aggrcssivc
Research Minsk,
Institute Belarus.
of Oncology
and
From 1970 through 1989, 112 small-cell lung cancer (SCLC) patients received surgical treatment and combination therapy at the Thoracic Department of RIOMR. As one of the components of the therapy, 35 patients were i.v. administered 19sAu with total activity of 1.5-1.9 GBq during the first 5 days after surgery. Of the total number of SCLC patients, 23% survived for 5 years: 26% without metastases in regional lymph nodes and 10% with N1,2 SCLC combination treatment produced the best results in TlNOMO cases: 53% of the patients survived for 5 years. The combination of surgery and subsequent i.v. “‘Au isotope resulted in 5-year survival for 36% of SCLC patients. We consider it most advisable to include the surgical component in the definitive treatment of stage I (TlNO and T2MO) SCLC. In these cases it is preferable to employ either preoperative radiotherapy with enlarged and large dose fractionation (‘ITD 20 to 30 Gy) or postoperative i.v. “sAu. The remote results of stage II and III SCLC combination therapy are poor; multimodality treatment should be applied for these stages. CORDIS
tamponada
-
initial
sign of lung adenocarcinoma
Videnovic-Ivanov J, Vucinic V, Radosavljevic T, Skodric V, Filipovic S. Institute for Lung Disease and TB, Belgrade, Yugoslavia
During the last 5 years we have found a higher number of patients with adenocarcinoma, especially in women, compared with the previous 5 years. The aim of this work is to emphasise the one sign manifestations of lung adenocarcinoma. Among this group of patients we analysed one group of nine pts (all were female), mean age 43.2 years. All of them were hospitalized because of dyspnea and radiographic manifestations of pleural effusion. The radiographic finding of totally enlarged heart shadow was the main finding and required ultrasonographic examinations. After exploration, pericardy punction might be obtained: in four pts there was haemmorhagic effusion while in the rest of the pts pericardial effusion was serosy. After that, cytologic examination was obtained in nine pts, in four of them cells of adenocarcinoma were found. In the rest of the pts, five pts, the diagnosis of adenocarcinoma was obtained after pleural biopsy. Pleural effusions were found in five pts on the left side, in hvo on the right side and in two pts bilaterally. Medical treatment was carried out in all of them: specific oncologic therapy in five pts. In two pts exitus letalis were obtained soon after admission to the hospital - mean time was 27.2 days, in four pts exitus letalis manifested in a mean time of 6.4 months but in three pts specific oncologic therapy was still delivered periodically and the results arc encouraging. Incidence and chemoradiotherapy
clinical significance of for advanced non-small
anaemia during cell lung cancer
Zemanovh M, Petruielka L, Zatloukal P, Judas L, Krejbich M. Dept. of Oncology, Czech Rep.
I”’ Medical
Faculty,
Charles
Uniu.,
Prague,
There are still too little data to assess the overall importance of anaemia in radiotherapy. However, there is strong
S61
evidence that a low Hb concentration is detrimental to local control and even within the range of normal Hb, variations may change the radiation response. While there seems to be conflicting data in assessing the overall importance of anaemia in radiation, there are some data that clearly show that uncorrected anaemia is detrimental to local control in some sites. Chemotherapy combined with radiotherapy may improve the disease control but commonly causes anaemia or worsens the mild anaemia associated with cancer. We evaluated incidence of anacmia in a group of patients treated with concurrent chemoradiotherapy using cisplatin plus vinorelbin (Zatloukal, Petruielka, Zemanoti et al. ASCO 1998). Results: From 7/96 to 12/97 19 pts with non-small-cell lung cancer were treated with concurrent chemoradiotherapy, 14 M, 5 F. Mean age 60 (range 44-70). Clinical stage IIIA: 3, IIIB: 16. Hb before treatment start: 1 patient Hb = 10 g/dl, 3 Hb < 11. Mean Hb before treatment start 13.1, mean Hb at the end of radiation 10.8. Mean nadir Hb during treatment 9.8. Number of patients with nadir Hb < 10.5: 10 (63.1%). Mean Hb drop 3.2. We evaluated treatment response relation to age, sex, PS, stage, number of chemotherapy cycles, Hb level before treatment start, at the end of radiation and Hb nadir by univariate analysis. Conciusion: We observed a significant proportion of patients with a drop of haemoglobin during the treatment course. Treatment response is in statistically significant correlation with the number of chemotherapy cycles. There was no correlation with other evaluated factors. WC will start a randomized trial to evaluate the effects of preventing anaemia with erythropoietin for patients with lung cancer undergoing concurrent chemoradiotherapy. Supported by grant IGA Mzd 3790-3.
Multidisciplinary
approach
to microcytoma
of the lung
Ruggieri M, Scocchera F, Carncvale L, Mascaro A, Misciagna A, Haughn C*. Uniuersi~ of Rome, Rome, Italy. *Ohio State University,
Columbus,
USA.
Twenty-six patients were diagnosed with microcytoma of the lung in stages I, II, and IIla. Our treatment strategy for stage I disease included surgery followed by chemotherapy. In stages II and IIIa we used prcopcrativc chemotherapy and thoracic irradiation followed by surgical treatment and adjuvant chemotherapy. Prophylactic cranial irradiation was rcscrvcd for some patients in complete remission. Mean survival rates were 16 months for stage I, 10 months for stage II, and 6 months for stage IIIa disease. For many years surgery was considcrcd contraindicated in the treatment of pulmonary microcytoma. Now, a multidisciplinary approach is being used in which surgery has a crucial role. Accurate staging is important for determining treatment. A review of literature shows that the use of surgery, chcmothcrapy and radiotherapy arc all important in treatment of microcytoma. Chemotherapy is used preopcratively to improve local control, decrease ncoplastic mass, induce histological regression, and as adjuvant therapy. Radiotherapy is shown to be affective prcopcrativcly to rcducc local mass and prophylactically for ccrcbral metastasis. Surgery is crucial to irradicatc the neo-plastic mass, improve staging accuracy, dccrcase local recurrence, and allow less aggrcssivc